pharmacology Flashcards
what are the benefits of using more than one drug during treatment
- enhance therapeutic benefit
- minimize drug toxicity
- minimize drug-induced resistance
multi drug approach for HIV:
what are the drugs, and what are their targets
- HIV binding, CCR5 antagonist = maraviroc
- HIV fusion (bind to gp41) = enfuvirtide
- NRTIs/NNRTIs = zidovudine/nevirapine
- integrase inhibitors = raltegravir
- protease inhibitors (maturation) = saquinavir
explain what pharmacokinetic boosting is and give example
enhancing the efficacy of a drug by adding another drug
- eg. giving ritonavir (potent inhibitor of Cyp3a4) with lopinavir
explain the combination therapy for HCV
sofosbuvir + PEG-interferon + ribavarin
Sofosbuvir + ribavirin
Action of sofosbuvir
nucleotide inhibitor of NS5B (RNA dep RNA polymerase)
empiric treatment of staph aureus or enterococcus faecalis and the drug action
gentamicin+penicillin
gentamycin - protein synthesis inhibition
penicillin - cell wall inhibition
explain the drug synergy of flucytosine and amphotericin
amphotericin b destroys the cell wall so flucytosine can more easily access the ribosome
explain the drug synergy in the treatment of pseudomonas jiroveci
sulfonamides and trimethoprim both act and two different parts of the folate pathway
explain the drug synergy in the treatment of testicular cancer
cisplatin and bleomycin = cause DNA damage/strand breaks
etoposide = inhibition of repair of the breaks
what are the 6 targets for for immunosuppression and what is a drug name for each
- glucocorticoids = prednisolone
- cytotoxic drugs = azathioprine
- calcineurin inhibitor = cyclosporin
- targeting cytokine receptors or cytokine = daclizumab
- t-lymphocyte depletion = anti-thymocyte globulin
- co-stimulation block = abatacept
explain the “induction” and “maintenance” immunosuppressant regimens
induction - T cell depletion (antibody mediated)
maintenance - calcineurin inhibitor, glucocorticosteroid, cytotoxic drug
how does genomic variation lead to a change in phenotype/drug responsitivity
- change in protein structure and or function
- change in gene transcription and hence quantity of protein produced
how does SNPs affect statin metabolism
SNP in SLCO1B1 gene reduces statin uptake ==> enhancing toxitiy
what are the two major mutations leading to non-small cell lung cancer and what are the drugs that treat them
EGFR mutation - gefitinib
ALK rearragement - crizotinib
which SNP predicts poor response to anti-leukotriene therapies
mutation in the promotor of 5-lipoxygenase gene
